National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (4)
- Adverse Events (3)
- Ambulatory Care and Surgery (2)
- Autism (1)
- Back Health and Pain (1)
- Behavioral Health (3)
- Blood Thinners (1)
- Cancer (3)
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- Comparative Effectiveness (1)
- Data (4)
- Dementia (1)
- Diabetes (2)
- Diagnostic Safety and Quality (3)
- Education: Patient and Caregiver (5)
- Elderly (3)
- (-) Electronic Health Records (EHRs) (58)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Delivery (3)
- Health Information Exchange (HIE) (3)
- (-) Health Information Technology (HIT) (58)
- Health Literacy (2)
- Health Services Research (HSR) (1)
- Health Status (1)
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- Medical Errors (2)
- Medication (5)
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- Organizational Change (1)
- Outcomes (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (1)
- Patient and Family Engagement (3)
- Patient Experience (1)
- Patient Safety (12)
- Pneumonia (1)
- Policy (1)
- Practice Patterns (1)
- Pregnancy (1)
- Pressure Ulcers (1)
- Prevention (1)
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- Provider (3)
- Provider: Clinician (1)
- Provider: Health Personnel (1)
- Provider: Nurse (2)
- Provider: Physician (2)
- Public Health (1)
- Quality Improvement (3)
- Quality Measures (1)
- Quality of Care (3)
- Registries (2)
- Research Methodologies (1)
- Risk (4)
- Shared Decision Making (3)
- Stress (1)
- Surgery (2)
- System Design (1)
- Teams (1)
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- Tools & Toolkits (1)
- Vulnerable Populations (2)
- Web-Based (5)
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- Young Adults (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
26 to 50 of 58 Research Studies DisplayedMeyer AND, Murphy DR, Al-Mutairi A
Electronic detection of delayed test result follow-up in patients with hypothyroidism.
Researchers developed and tested an electronic health record (EHR)-based trigger algorithm to identify instances of delayed follow-up of abnormal thyroid-stimulating hormone (TSH) results in patients being treated for hypothyroidism. Their automated trigger algorithm applied to records in a large EHR data warehouse was able to identify patients with hypothyroidism with potential delays in thyroid function test results follow-up.
AHRQ-funded; HS022901.
Citation: Meyer AND, Murphy DR, Al-Mutairi A .
Electronic detection of delayed test result follow-up in patients with hypothyroidism.
J Gen Intern Med 2017 Jul;32(7):753-59. doi: 10.1007/s11606-017-3988-z.
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Keywords: Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT)
Brown SD, Grijalva CS, Ferrara A
Leveraging EHRs for patient engagement: perspectives on tailored program outreach.
Electronic health records (EHRs) present healthcare delivery systems with scalable, cost-effective opportunities to promote lifestyle programs among patients at high risk for type 2 diabetes, yet little consensus exists on strategies to enhance patient engagement. In this study, the investigators explored patient perspectives on program outreach messages containing content tailored to EHR-derived diabetes risk factors--a theory-driven strategy to increase the persuasiveness of health communications.
AHRQ-funded; HS019367.
Citation: Brown SD, Grijalva CS, Ferrara A .
Leveraging EHRs for patient engagement: perspectives on tailored program outreach.
Am J of Manag Care 2017 Jul;23(7):e223-e30..
Keywords: Diabetes, Communication, Education: Patient and Caregiver, Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare Delivery, Lifestyle Changes, Patient and Family Engagement
Furukawa MF, Spector WD, Rhona Limcangco M
AHRQ Author: Furukawa MF, Spector WD, Encinosa WE
Meaningful use of health information technology and declines in in-hospital adverse drug events.
Hospital adoption of electronic health records with Meaningful Use (MU) capabilities expected to improve medication safety has grown rapidly. This study has found that MU capabilities and interoperability were associated with lower occurrence of adverse drug events (ADEs), but the effects did not vary by experience with MU. About one-fifth of the decline in ADEs from 2010 to 2013 was attributable to MU capabilities.
AHRQ-authored.
Citation: Furukawa MF, Spector WD, Rhona Limcangco M .
Meaningful use of health information technology and declines in in-hospital adverse drug events.
J Am Med Inform Assoc 2017 Jul 1;24(4):729-36. doi: 10.1093/jamia/ocw183.
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Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Adverse Drug Events (ADE), Patient Safety, Hospitals
Kelley C, Lee B, Wilcox L
Self-tracking for mental wellness: understanding expert perspectives and student experiences.
Recent studies with college student populations have examined the feasibility of collecting everyday mood, activity, and social data. However, these studies do not account for students' experiences and challenges adopting self-tracking technologies to support mental wellness goals. In this paper, the authors present two studies conducted to better understand self-tracking for stress management and mental wellness in student populations.
AHRQ-funded; HS021393.
Citation: Kelley C, Lee B, Wilcox L .
Self-tracking for mental wellness: understanding expert perspectives and student experiences.
Proc SIGCHI Conf Hum Factor Comput Syst 2017 May 2;2017:629-41. doi: 10.1145/3025453.3025750..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Behavioral Health, Stress, Young Adults
Kellogg KM, Fairbanks RJ, Ratwani RM
EHR usability: get it right from the start.
The authors discuss shortfalls of the current EHR systems and make recommendations for the development of next-generation systems.
AHRQ-funded; HS023701.
Citation: Kellogg KM, Fairbanks RJ, Ratwani RM .
EHR usability: get it right from the start.
Biomed Instrum Technol 2017 May/Jun;51(3):197-99. doi: 10.2345/0899-8205-51.3.197.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT)
Banerji A, Blumenthal KG, Lai KH
Epidemiology of ACE inhibitor angioedema utilizing a large electronic health record.
The objective of this study was to identify the incidence of and risk factors for angioedema caused by angiotensin-converting enzyme inhibitors (ACEIs) using a large integrated electronic health record (EHR). It concluded that the incidence of ACEI angioedema within a large EHR is consistent with large clinical trial data. A history of nonsteroidal anti-inflammatory drug allergy was identified as a risk factor for patients with ACEI angioedema.
AHRQ-funded; HS022728.
Citation: Banerji A, Blumenthal KG, Lai KH .
Epidemiology of ACE inhibitor angioedema utilizing a large electronic health record.
J Allergy Clin Immunol Pract 2017 May - Jun;5(3):744-49. doi: 10.1016/j.jaip.2017.02.018.
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Keywords: Electronic Health Records (EHRs), Medication, Risk, Health Information Technology (HIT), Adverse Drug Events (ADE)
Zikmund-Fisher BJ, Scherer AM, Witteman HO
Graphics help patients distinguish between urgent and non-urgent deviations in laboratory test results.
Most electronic health record systems provide laboratory test results to patients in table format. Researchers tested whether presenting such results in visual displays (number lines) could improve understanding. They found that visual displays reduced respondents' perceived urgency and desire to contact health care providers immediately for near-normal test results compared to tables but did not affect their perceptions of extreme values.
AHRQ-funded; HS021681.
Citation: Zikmund-Fisher BJ, Scherer AM, Witteman HO .
Graphics help patients distinguish between urgent and non-urgent deviations in laboratory test results.
J Am Med Inform Assoc 2017 May 1;24(3):520-28. doi: 10.1093/jamia/ocw169.
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Keywords: Communication, Education: Patient and Caregiver, Shared Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT)
Calvitti A, Hochheiser H, Ashfaq S
Physician activity during outpatient visits and subjective workload.
The researchers describe methods for capturing and analyzing EHR use and clinical workflow of physicians during outpatient encounters and relating activity to physicians' self-reported workload. They found that visit activity was highly variable across individual physicians, and the observed activity metrics ranged widely as correlates to subjective workload.
AHRQ-funded; HS021290.
Citation: Calvitti A, Hochheiser H, Ashfaq S .
Physician activity during outpatient visits and subjective workload.
J Biomed Inform 2017 May;69:135-49. doi: 10.1016/j.jbi.2017.03.011.
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Keywords: Healthcare Delivery, Electronic Health Records (EHRs), Health Information Technology (HIT), Workflow, Ambulatory Care and Surgery
Lybarger K, Ostendorf M, Yetisgen M
Automatically detecting likely edits in clinical notes created using automatic speech recognition.
Aiming to reduce the time required to edit automatic speech recognition (ASR) transcripts, this paper investigates novel methods for automatic detection of edit regions within the transcripts, including both putative ASR errors but also regions that are targets for cleanup or rephrasing.
AHRQ-funded; HS023631.
Citation: Lybarger K, Ostendorf M, Yetisgen M .
Automatically detecting likely edits in clinical notes created using automatic speech recognition.
AMIA Annu Symp Proc 2017 Apr 16;2017:1186-95.
Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Data
Ancker JS, Edwards A, Nosal S
Effects of workload, work complexity, and repeated alerts on alert fatigue in a clinical decision support system.
In this study, the investigators tested hypotheses arising from two possible alert fatigue mechanisms: (A) cognitive overload associated with amount of work, complexity of work, and effort distinguishing informative from uninformative alerts, and (B) desensitization from repeated exposure to the same alert over time. The investigators found that clinicians became less likely to accept alerts as they received more of them, particularly more repeated alerts. There was no evidence of an effect of workload per se, or of desensitization over time for a newly deployed alert.
AHRQ-funded; HS021531.
Citation: Ancker JS, Edwards A, Nosal S .
Effects of workload, work complexity, and repeated alerts on alert fatigue in a clinical decision support system.
BMC Med Inform Decis Mak 2017 Apr 10;17(1):1-9. doi: 10.1186/s12911-017-0430-8..
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety, Provider, Provider: Nurse, Provider: Physician
Kim KK, Sankar P, Wilson MD
Factors affecting willingness to share electronic health data among California consumers.
The objective of the study is to explore factors that affect consumers' willingness to share electronic health information for healthcare and research. It concluded that consumers' choices about electronically sharing health information are affected by their attitudes toward EHRs as well as beliefs about research benefit and individual control.
AHRQ-funded; HS019913.
Citation: Kim KK, Sankar P, Wilson MD .
Factors affecting willingness to share electronic health data among California consumers.
BMC Med Ethics 2017 Apr 4;18(1):25. doi: 10.1186/s12910-017-0185-x.
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Keywords: Communication, Electronic Health Records (EHRs), Health Information Exchange (HIE), Health Information Technology (HIT), Research Methodologies
Ratwani RM, Hettinger AZ, Fairbanks RJ
Barriers to comparing the usability of electronic health records.
In this paper, the authors describe the importance of providing purchasers with improved information about electronic health record usability, barriers to making usability comparisons, and solutions to overcome these barriers.
AHRQ-funded; HS023701.
Citation: Ratwani RM, Hettinger AZ, Fairbanks RJ .
Barriers to comparing the usability of electronic health records.
J Am Med Inform Assoc 2017 Apr 1;24(e1):e191-e93. doi: 10.1093/jamia/ocw117..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT)
Tai-Seale M, Olson CW, Li J
Electronic health record logs indicate that physicians split time evenly between seeing patients and desktop medicine.
The researchers used data on physicians' time allocation patterns captured by over thirty-one million EHR transactions in the period 2011-14 recorded by 471 primary care physicians, who collectively worked on 765,129 patients' EHRs. Their results suggest that the physicians logged an average of 3.08 hours on office visits and 3.17 hours on desktop medicine each day.
AHRQ-funded; HS019167.
Citation: Tai-Seale M, Olson CW, Li J .
Electronic health record logs indicate that physicians split time evenly between seeing patients and desktop medicine.
Health Aff 2017 Apr;36(4):655-62. doi: 10.1377/hlthaff.2016.0811.
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Keywords: Clinician-Patient Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Practice Patterns
Duckworth M, Leung E, Fuller T
Nurse, patient, and care partner perceptions of a personalized safety plan screensaver.
A patient safety plan dashboard was developed that captures disparate data from the electronic health record that is then displayed as a personalized bedside screensaver. End user perceptions of the content and interface of the personalized safety plan screensavers were identified and strategies to overcome the barriers to use for future iterations were defined. Differences emerged stemming from each group of end users' role on the care team.
AHRQ-funded; HS023535.
Citation: Duckworth M, Leung E, Fuller T .
Nurse, patient, and care partner perceptions of a personalized safety plan screensaver.
J Gerontol Nurs 2017 Apr;43(4):15-22. doi: 10.3928/00989134-20170313-05.
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Keywords: Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT), Caregiving, Patient Safety, Patient and Family Engagement, Care Coordination
Tieu L, Schillinger D, Sarkar U
Online patient websites for electronic health record access among vulnerable populations: portals to nowhere?
The objective of this study was to examine specific usability barriers to patient portal engagement among a diverse group of patients and caregivers. In navigating the portal, participants experienced basic computer barriers (eg, difficulty using a mouse), routine computer barriers (eg, mistyping, navigation issues), reading/writing barriers, and medical content barriers.
AHRQ-funded; HS022408; HS022561.
Citation: Tieu L, Schillinger D, Sarkar U .
Online patient websites for electronic health record access among vulnerable populations: portals to nowhere?
J Am Med Inform Assoc 2017 Apr 1;24(e1):e47-e54. doi: 10.1093/jamia/ocw098.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Health Literacy, Vulnerable Populations, Web-Based
Makam AN, Nguyen OK, Clark C
Predicting 30-day pneumonia readmissions using electronic health record data.
The objective of this study was to develop pneumonia-specific readmission risk-prediction models using EHR data from the first day and from the entire hospital stay ("full stay"). The investigators concluded that EHR data collected from the entire hospitalization can accurately predict readmission risk among patients hospitalized for pneumonia. They suggest that this approach outperforms a first-day pneumonia-specific model, the Centers for Medicare and Medicaid Services pneumonia model, and 2 commonly used pneumonia severity of illness scores.
AHRQ-funded; HS022418.
Citation: Makam AN, Nguyen OK, Clark C .
Predicting 30-day pneumonia readmissions using electronic health record data.
J Hosp Med 2017 Apr;12(4):209-16. doi: 10.12788/jhm.2711..
Keywords: Pneumonia, Hospital Readmissions, Hospitalization, Electronic Health Records (EHRs), Health Information Technology (HIT)
Hu Z, Melton GB, Arsoniadis EG
Strategies for handling missing clinical data for automated surgical site infection detection from the electronic health record.
Proper handling of missing data is important for many secondary uses of electronic health record (EHR) data. Data imputation methods can be used to handle missing data, but their use for postoperative complication detection is unclear. Overall, models with missing data imputation almost always outperformed reference models without imputation that included only cases with complete data for detection of SSI overall achieving very good average area under the curve values.
AHRQ-funded; HS024532.
Citation: Hu Z, Melton GB, Arsoniadis EG .
Strategies for handling missing clinical data for automated surgical site infection detection from the electronic health record.
J Biomed Inform 2017 Apr;68:112-20. doi: 10.1016/j.jbi.2017.03.009.
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Keywords: Data, Electronic Health Records (EHRs), Healthcare-Associated Infections (HAIs), Registries, Surgery, Injuries and Wounds, Health Information Technology (HIT), Quality Improvement, Quality of Care, Adverse Events
Padula WV, Gibbons RD, Pronovost PJ
Using clinical data to predict high-cost performance coding issues associated with pressure ulcers: a multilevel cohort model.
Hospital-acquired pressure ulcers (HAPUs) have a mortality rate of 11.6 percent, are costly to treat, and result in Medicare reimbursement penalties. The study’s objective was to use electronic health records to predict pressure ulcers and to identify coding issues leading to penalties. Its analysis identified spinal cord injuries as high risk for HAPUs and as being often inappropriately coded without paralysis.
AHRQ-funded; HS023710.
Citation: Padula WV, Gibbons RD, Pronovost PJ .
Using clinical data to predict high-cost performance coding issues associated with pressure ulcers: a multilevel cohort model.
J Am Med Inform Assoc 2017 Apr 1;24(e1):e95-e102. doi: 10.1093/jamia/ocw118.
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Keywords: Pressure Ulcers, Healthcare-Associated Infections (HAIs), Electronic Health Records (EHRs), Health Information Technology (HIT)
Murphy DR, Meyer AN, Vaghani V
Application of electronic algorithms to improve diagnostic evaluation for bladder cancer.
The researchers evaluated the performance of electronic trigger algorithms to detect delays in hematuria follow-up. They concluded that triggers offer a promising method to detect delays in care of patients with high-grade hematuria and warrant further evaluation in clinical practice as a means to reduce delays in bladder cancer diagnosis.
AHRQ-funded; HS022901.
Citation: Murphy DR, Meyer AN, Vaghani V .
Application of electronic algorithms to improve diagnostic evaluation for bladder cancer.
Appl Clin Inform 2017 Mar 22;8(1):279-90. doi: 10.4338/aci-2016-10-ra-0176.
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Keywords: Cancer, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT)
Revere D, Hills RH, Dixon BE
Notifiable condition reporting practices: implications for public health agency participation in a health information exchange.
The researchers sought to better understand the barriers to and burden of notifiable condition reporting from the perspectives of clinic physicians, interviews with clinic reporters, and interviews with public health workers involved in reporting workflow. A strong recommendation generated by their findings is that, given their central role in reporting, clinic reporters are a significant target audience for public health outreach and education that aims to alleviate perceived reporting burden and improve reporting knowledge.
AHRQ-funded; HS020909.
Citation: Revere D, Hills RH, Dixon BE .
Notifiable condition reporting practices: implications for public health agency participation in a health information exchange.
BMC Public Health 2017 Mar 11;17(1):247. doi: 10.1186/s12889-017-4156-4.
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Keywords: Health Information Exchange (HIE), Public Health, Infectious Diseases, Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Physician, Provider: Clinician, Provider
Gerber DE, Beg MS, Duncan T
Oncology nursing perceptions of patient electronic portal use: a qualitative analysis.
The purpose of this study was to identify nursing staff reactions to and perceptions of electronic portal use in a cancer setting. Two focus groups were conducted and theoretical thematic content analysis of data was performed. The investigators concluded that nursing staff reactions to electronic portals were predominantly related to the impact on clinical workload and patient safety and expectations.
AHRQ-funded; HS022418.
Citation: Gerber DE, Beg MS, Duncan T .
Oncology nursing perceptions of patient electronic portal use: a qualitative analysis.
Oncol Nurs Forum 2017 Mar 1;44(2):165-70. doi: 10.1188/17.Onf.165-170..
Keywords: Cancer, Electronic Health Records (EHRs), Health Information Technology (HIT), Provider, Provider: Nurse
Tonner C, Schmajuk G, Yazdany J
A new era of quality measurement in rheumatology: electronic clinical quality measures and national registries.
This article reviews the evolution of quality measurement in rheumatology, highlighting new health-information technology infrastructure and standards that are enabling unprecedented innovation in this field. Its authors assert that quality measurement and improvement is increasingly an essential component of rheumatology practice. Advances in health information technology are likely to continue to make implementation of electronic clinical quality measures (eCQMs) easier and measurement more clinically meaningful and accurate in coming years.
AHRQ-funded; HS024412.
Citation: Tonner C, Schmajuk G, Yazdany J .
A new era of quality measurement in rheumatology: electronic clinical quality measures and national registries.
Curr Opin Rheumatol 2017 Mar;29(2):131-37. doi: 10.1097/bor.0000000000000364.
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Keywords: Quality Measures, Registries, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement
Daley MF, Newton DA, DeBar L
Accuracy of electronic health record-derived data for the identification of incident ADHD.
The purpose of this study was to assess the accuracy of electronic health record (EHR)-derived diagnoses in identifying children with incident (i.e., newly diagnosed) ADHD. The authors describe their study and suggest that studies predicated on the identification of incident ADHD cases need to carefully consider study designs that minimize the likelihood of case misclassification.
AHRQ-funded; HS019912.
Citation: Daley MF, Newton DA, DeBar L .
Accuracy of electronic health record-derived data for the identification of incident ADHD.
J Atten Disord 2017 Mar;21(5):416-25. doi: 10.1177/1087054713520616..
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Behavioral Health
Roman LC, Ancker JS, Johnson SB
Navigation in the electronic health record: a review of the safety and usability literature.
The purpose of this literature review was to improve access to navigation-related research in usability. Specifically, the investigators aimed to (1) assess the prevalence of navigation-related topics within the EHR usability and safety research literature, (2) categorize types of navigation actions within the EHR, (3) capture relationships between these navigation actions and usability principles, and (4) collect terms and concepts related to EHR navigation.
AHRQ-funded; HS023708.
Citation: Roman LC, Ancker JS, Johnson SB .
Navigation in the electronic health record: a review of the safety and usability literature.
J Biomed Inform 2017 Mar;67:69-79. doi: 10.1016/j.jbi.2017.01.005..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety
Takyi H, Watzlaf V, Matthews JT
Privacy and security in multi-user health kiosks.
Preservation of privacy and security are an integral part of health technology development. This paper provides a guide, based on the Office for Civil Rights (OCR) audit protocol, for creating and maintaining an audit checklist for multi-user health kiosks. Implementation of selected audit elements for a multi-user health kiosk designed for use by community-residing older adults illustrates how the guide can be applied.
AHRQ-funded; HS022889.
Citation: Takyi H, Watzlaf V, Matthews JT .
Privacy and security in multi-user health kiosks.
Int J Telerehabil 2017 Spring;9(1):3-14. doi: 10.5195/ijt.2017.6217.
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Keywords: Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT)